| Regimental number | 4177 |
| Place of birth | Riverstone New South Wales |
| Religion | Church of England |
| Occupation | Slaughterman |
| Address | Riverstone, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mr A Drake, Riverstone, New South Wales |
| Enlistment date | 14 July 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A60 Aeneas on 20 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Battalion |
| Fate | Returned to Australia 12 May 1919 |
